SPECIAL TOPICS
ORIGINAL RESEARCH: FEATURED
ABSTRACT FROM THE 19TH NATIONAL CONFERENCE ON CHRONIC DISEASE
PREVENTION AND CONTROL
Colorectal Cancer Screening in Washington State: Predictors
of Current Screening and Explanations for No Screening

The purpose of this study was to identify predictors of
current colorectal cancer screening in Washington State and to
examine participants’ reasons for not being screened.

We analyzed data from the 2002 Behavioral Risk Factor
Surveillance System for Washington State residents aged 50 years
and older (N = 2109). Current colorectal cancer screening was
defined as having a fecal occult blood test (FOBT) within the
past year and/or sigmoidoscopy or colonoscopy within the past five
years. Participants who did not have current FOBT or current
endoscopy were asked the primary reason for not obtaining
screening.

Overall, current colorectal cancer screening was reported by
51.9% of the sample (FOBT by 25.8%; endoscopy by 42.8%).
Univariate analyses showed that several demographic characteristics were
significantly associated
with screening status, including white race (P = .04), aged 65 years or
older (P < .001), annual income more than $75,000 (P < .001), and having a college
degree (P = .02).

In a multivariate analysis adjusting for the above characteristics and other
likely confounding variables (e.g., sex, marital status), participants were
significantly more likely to have current screening if they possessed
health insurance (54.2% vs 16.8% for uninsured participants, P < .001) and
had discussed colorectal cancer screening with a health care
provider (67.3% vs 33.4% for participants who had never discussed
screening with a health care provider, P < .001). Participants were also
significantly more likely to report current screening if they
lived in a large town or urban area (53.0% vs 42.7% for
participants living in small towns/rural areas; P =
.05).

The majority of participants without current screening
cited lack of awareness as the primary reason for not being
screened (53.0% for FOBT; 46.9% for endoscopy). An additional
group of participants stated their physicians had not recommended
screening (24.8% for FOBT; 33.3% for endoscopy). Relatively few
participants said they were not willing to be screened (20.4% for
FOBT; 18.1% for endoscopy) or cited lack of access (1.8% each for
FOBT and endoscopy).

Our results indicate that nearly half of age-appropriate
Washington State residents lack current colorectal cancer
screening. Awareness of colorectal cancer screening, particularly
via speaking with a health care provider, was an important
predictor of screening. These findings are consistent with
published reports based on National Health Interview Survey data.
Interventions should be developed to increase awareness of and
physician recommendations for colorectal cancer screening,
particularly among disadvantaged patient populations.

The opinions expressed by authors contributing to this
journal do not necessarily reflect the opinions of the U.S. Department of Health
and Human Services, the Public Health Service, the Centers for Disease Control and
Prevention, or the authors’ affiliated institutions. Use of trade names is for
identification only and does not imply endorsement by any of the groups named
above.